Deep learning cardiac motion analysis for human survival prediction

Motion analysis is used in computer vision to understand the behaviour of moving objects in sequences of images. Optimising the interpretation of dynamic biological systems requires accurate and precise motion tracking as well as efficient representations of high-dimensional motion trajectories so that these can be used for prediction tasks. Here we use image sequences of the heart, acquired using cardiac magnetic resonance imaging, to create time-resolved three-dimensional segmentations using a fully convolutional network trained on anatomical shape priors. This dense motion model formed the input to a supervised denoising autoencoder (4Dsurvival), which is a hybrid network consisting of an autoencoder that learns a task-specific latent code representation trained on observed outcome data, yielding a latent representation optimised for survival prediction. To handle right-censored survival outcomes, our network used a Cox partial likelihood loss function. In a study of 302 patients the predictive accuracy (quantified by Harrell's C-index) was significantly higher (p < .0001) for our model C=0.73 (95$\%$ CI: 0.68 - 0.78) than the human benchmark of C=0.59 (95$\%$ CI: 0.53 - 0.65). This work demonstrates how a complex computer vision task using high-dimensional medical image data can efficiently predict human survival

Recent publications from the Alzheimer's Disease Neuroimaging Initiative: Reviewing progress toward improved AD clinical trials

INTRODUCTION: The Alzheimer's Disease Neuroimaging Initiative (ADNI) has continued development and standardization of methodologies for biomarkers and has provided an increased depth and breadth of data available to qualified researchers. This review summarizes the over 400 publications using ADNI data during 2014 and 2015. METHODS: We used standard searches to find publications using ADNI data. RESULTS: (1) Structural and functional changes, including subtle changes to hippocampal shape and texture, atrophy in areas outside of hippocampus, and disruption to functional networks, are detectable in presymptomatic subjects before hippocampal atrophy; (2) In subjects with abnormal β-amyloid deposition (Aβ+), biomarkers become abnormal in the order predicted by the amyloid cascade hypothesis; (3) Cognitive decline is more closely linked to tau than Aβ deposition; (4) Cerebrovascular risk factors may interact with Aβ to increase white-matter (WM) abnormalities which may accelerate Alzheimer's disease (AD) progression in conjunction with tau abnormalities; (5) Different patterns of atrophy are associated with impairment of memory and executive function and may underlie psychiatric symptoms; (6) Structural, functional, and metabolic network connectivities are disrupted as AD progresses. Models of prion-like spreading of Aβ pathology along WM tracts predict known patterns of cortical Aβ deposition and declines in glucose metabolism; (7) New AD risk and protective gene loci have been identified using biologically informed approaches; (8) Cognitively normal and mild cognitive impairment (MCI) subjects are heterogeneous and include groups typified not only by "classic" AD pathology but also by normal biomarkers, accelerated decline, and suspected non-Alzheimer's pathology; (9) Selection of subjects at risk of imminent decline on the basis of one or more pathologies improves the power of clinical trials; (10) Sensitivity of cognitive outcome measures to early changes in cognition has been improved and surrogate outcome measures using longitudinal structural magnetic resonance imaging may further reduce clinical trial cost and duration; (11) Advances in machine learning techniques such as neural networks have improved diagnostic and prognostic accuracy especially in challenges involving MCI subjects; and (12) Network connectivity measures and genetic variants show promise in multimodal classification and some classifiers using single modalities are rivaling multimodal classifiers. DISCUSSION: Taken together, these studies fundamentally deepen our understanding of AD progression and its underlying genetic basis, which in turn informs and improves clinical trial desig

Doctor of Philosophy

dissertationMagnetic Resonance (MR) is a relatively risk-free and flexible imaging modality that is widely used for studying the brain. Biophysical and chemical properties of brain tissue are captured by intensity measurements in T1W (T1-Weighted) and T2W (T2-Weighted) MR scans. Rapid maturational processes taking place in the infant brain manifest as changes in co{\tiny }ntrast between white matter and gray matter tissue classes in these scans. However, studies based on MR image appearance face severe limitations due to the uncalibrated nature of MR intensity and its variability with respect to changing conditions of scan. In this work, we develop a method for studying the intensity variations between brain white matter and gray matter that are observed during infant brain development. This method is referred to by the acronym WIVID (White-gray Intensity Variation in Infant Development). WIVID is computed by measuring the Hellinger Distance of separation between intensity distributions of WM (White Matter) and GM (Gray Matter) tissue classes. The WIVID measure is shown to be relatively stable to interscan variations compared with raw signal intensity and does not require intensity normalization. In addition to quantification of tissue appearance changes using the WIVID measure, we test and implement a statistical framework for modeling temporal changes in this measure. WIVID contrast values are extracted from MR scans belonging to large-scale, longitudinal, infant brain imaging studies and modeled using the NLME (Nonlinear Mixed Effects) method. This framework generates a normative model of WIVID contrast changes with time, which captures brain appearance changes during neurodevelopment. Parameters from the estimated trajectories of WIVID contrast change are analyzed across brain lobes and image modalities. Parameters associated with the normative model of WIVID contrast change reflect established patterns of region-specific and modality-specific maturational sequences. We also detect differences in WIVID contrast change trajectories between distinct population groups. These groups are categorized based on sex and risk/diagnosis for ASD (Autism Spectrum Disorder). As a result of this work, the usage of the proposed WIVID contrast measure as a novel neuroimaging biomarker for characterizing tissue appearance is validated, and the clinical potential of the developed framework is demonstrated

Mapping Cortical Morphology in Youth With Velocardiofacial (22q11.2 Deletion) Syndrome

Objective: Velo-cardio-facial syndrome (VCFS; 22q11.2 deletion syndrome) represents one of the highest known risk factors for schizophrenia. Insofar as up to thirty percent of individuals with this genetic disorder develop schizophrenia, VCFS constitutes a unique, etiologically homogeneous model for understanding the pathogenesis of schizophrenia. Method: Using a longitudinal, case-control design, we acquired anatomic magnetic resonance images to investigate both cross-sectional and longitudinal alterations in surface cortical morphology in a cohort of adolescents with VCFS and age-matched typical controls. All participants were scanned at two time points. Results: Relative to controls, youth with VCFS exhibited alterations in inferior frontal, dorsal frontal, occipital, and cerebellar brain regions at both time points. We observed little change over time in surface morphology of either study group. However, within the VCFS group only, worsening psychosocial functioning over time was associated with Time 2 surface contractions in left middle and inferior temporal gyri. Further, prodromal symptoms at Time 2 were associated with surface contractions in left and right orbitofrontal, temporal and cerebellar regions, as well as surface protrusions of supramarginal gyrus. Conclusions: These findings advance our understanding of cortical disturbances in VCFS that produce vulnerability for psychosis in this high risk population

Analyzing Heterogeneity In Neuroimaging With Probabilistic Multivariate Clustering Approaches

Automated quantitative neuroimaging analysis methods have been crucial in elucidating normal and pathological brain structure and function, and in building in vivo markers of disease and its progression. Commonly used methods can identify and precisely quantify subtle and spatially complex imaging patterns of brain change associated with brain diseases. However, the overarching premise of these methods is that the disease group is a homogeneous entity resulting from a single, unifying pathophysiological process that has a single imaging signature. This assumption ignores ample evidence for the heterogeneous nature of neurodegenerative diseases and neuropsychiatric disorders, resulting in incomplete or misleading descriptions. Accurate characterization of heterogeneity is important for deepening our understanding of neurobiological processes, thus leading to improved disease diagnosis and prognosis. In this thesis, we leveraged machine learning techniques to develop novel tools that can analyze the heterogeneity in both cross-sectional and longitudinal neuroimaging studies. Specifically, we developed a semi-supervised clustering method for characterizing heterogeneity in cross-sectional group comparison studies, where normal and patient populations are modeled as high-dimensional point distributions, and heterogeneous disease effects are captured by estimating multiple transformations that align the two distributions, while accounting for the effect of nuisance covariates. Moreover, toward dissecting the heterogeneity in longitudinal cohorts, we proposed a method which simultaneously fits multiple population longitudinal multivariate trajectories and clusters subjects into subgroups. Longitudinal trajectories are modeled using spatiotemporally regularized cubic splines, while clustering is performed by assigning subjects to the subgroup whose population trajectory best fits their data. The proposed tools were extensively validated using synthetic data. Importantly, they were applied to study the heterogeneity in large clinical neuroimaging cohorts. We identified four disease subtypes with distinct imaging signatures using data from Alzheimer’s Disease Neuroimaging Initiative, and revealed two subgroups with different longitudinal patterns using data from Baltimore Longitudinal Study on Aging. Critically, we were able to further characterize the subgroups in each of the studies by performing statistical analyses evaluating subgroup differences with additional information such as neurocognitive data. Our results demonstrate the strength of the developed methods, and may pave the road for a broader understanding of the complexity of brain aging and Alzheimer’s disease

Machine Learning for Multiclass Classification and Prediction of Alzheimer\u27s Disease

Alzheimer\u27s disease (AD) is an irreversible neurodegenerative disorder and a common form of dementia. This research aims to develop machine learning algorithms that diagnose and predict the progression of AD from multimodal heterogonous biomarkers with a focus placed on the early diagnosis. To meet this goal, several machine learning-based methods with their unique characteristics for feature extraction and automated classification, prediction, and visualization have been developed to discern subtle progression trends and predict the trajectory of disease progression. The methodology envisioned aims to enhance both the multiclass classification accuracy and prediction outcomes by effectively modeling the interplay between the multimodal biomarkers, handle the missing data challenge, and adequately extract all the relevant features that will be fed into the machine learning framework, all in order to understand the subtle changes that happen in the different stages of the disease. This research will also investigate the notion of multitasking to discover how the two processes of multiclass classification and prediction relate to one another in terms of the features they share and whether they could learn from one another for optimizing multiclass classification and prediction accuracy. This research work also delves into predicting cognitive scores of specific tests over time, using multimodal longitudinal data. The intent is to augment our prospects for analyzing the interplay between the different multimodal features used in the input space to the predicted cognitive scores. Moreover, the power of modality fusion, kernelization, and tensorization have also been investigated to efficiently extract important features hidden in the lower-dimensional feature space without being distracted by those deemed as irrelevant. With the adage that a picture is worth a thousand words, this dissertation introduces a unique color-coded visualization system with a fully integrated machine learning model for the enhanced diagnosis and prognosis of Alzheimer\u27s disease. The incentive here is to show that through visualization, the challenges imposed by both the variability and interrelatedness of the multimodal features could be overcome. Ultimately, this form of visualization via machine learning informs on the challenges faced with multiclass classification and adds insight into the decision-making process for a diagnosis and prognosis